Intracranial arterial calcification and recurrent stroke and mortality: clinical associations and AI-based detection

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Ischaemic stroke (n=37). Intervention: Intracranial arterial calcification (IAC) vs. No intracranial arterial calcification. Primary outcome: Recurrent ischaemic stroke (HR 16.52, 95% CI 2.50-109.30, p=0.004).

Q: What does this research mean for the field?

Intracranial arterial calcification is independently associated with an increased hazard of recurrent ischaemic stroke, but is not significantly associated with all-cause mortality. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

Sandra Elsheikh; Jianyang Xie; Yuankai Wang; Greg J Irving; Andrew M. Hill; Yalin Zheng; Gregory Y.H. Lip; Azmil H. Abdul‐Rahim

doi:10.5114/aoms/241915

October 23, 2026Archives of Medical ScienceOpen Access

Intracranial arterial calcification and recurrent stroke and mortality: clinical associations and AI-based detection

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Key result

Intracranial arterial calcification is linked to ~16.5-fold higher risk of recurrent ischaemic stroke.

HR 16.52
95% CI 2.50-109.30
P=0.004
n=37

Why the study?

Whether intracranial arterial calcification (IAC) assessed by head computed tomography angiography predicts recurrent ischemic stroke and all-cause mortality in post-stroke patients remains unclear. Additionally, conventional manual assessment of IAC is subjective and inconsistent, requiring a more objective automated detection method.

Key Points

To evaluate the association between intracranial arterial calcification (IAC) and recurrent ischemic stroke or all-cause mortality, and to develop an artificial intelligence model for automated IAC detection on head CTA.
Evaluated the association between IAC and recurrent ischemic stroke and all-cause mortality using Cox proportional hazards models.
Developed a deep learning segmentation model for the automatic detection and segmentation of IAC on head computed tomography angiography (CTA) images.
Patients with IAC had a higher incidence of recurrent stroke than those without IAC, and IAC was independently associated with a higher hazard of ischemic stroke recurrence.
The automated deep learning segmentation model for IAC detection on head CTA achieved a Dice similarity coefficient (DSC) of 0.73 ±0.01.

Study Design

Type

Cohort (n=37)

PICO

P

Population

37 patients with ischaemic stroke (mean age 58.08 years) undergoing head CTA in the United Kingdom, followed for a median of 0.62 years.

E

Exposure / Comparator

Intracranial arterial calcification (IAC) vs No intracranial arterial calcification

O

Primary Outcome

Recurrent ischaemic stroke — HR 16.52 (2.50-109.30), p=0.004

Main Result

Hazard Ratio: 16.52 (95% CI 2.5–109.3)

Absolute Event Rate: 66.7% vs 31.2%

p-value: p=0.004

Limitations

Unmeasured confounders such as inflammatory markers and dynamic changes in disease status may have affected results
Limited sample size (n=37) restricted statistical power
Unable to explore the link between intracranial arterial calcification and atrial fibrillation due to small sample size
Exploratory approach to quantifying calcification burden has not yet been standardised or externally validated

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Implication

Does not support routine calcification assessment for recurrence risk; hypothesis-generating for prospective validation in larger cohorts.

Abstract

Introduction n/a Material and methods n/a Results n/a Conclusions n/a

Discussion

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Cite This Study

Elsheikh et al. (2026) conducted a cohort in Ischaemic stroke (n=37). Intracranial arterial calcification (IAC) vs. No intracranial arterial calcification was evaluated on Recurrent ischaemic stroke (HR 16.52, 95% CI 2.50-109.30, p=0.004). Intracranial arterial calcification was independently associated with a higher hazard of recurrent ischaemic stroke (adjusted HR 16.52, 95% CI 2.50-109.30, p=0.004) in post-stroke patients.

synapsesocial.com/papers/6aee6bb371a7594806220a59 https://doi.org/10.5114/aoms/241915

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Intracranial arterial calcification and recurrent stroke and mortality: clinical associations and AI-based detection

Key Points

Study Design

PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Intracranial arterial calcification and recurrent stroke and mortality: clinical associations and AI-based detection

Key Points

Study Design

PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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